What is RANZCOG doing to reduce birth trauma in Australia?

RANZCOG Board Director, Professor Boon Lim, says reducing birth trauma in Australia will need a system where everyone understands it; where midwives, obstetricians, GPs and Allied Health are equipped to manage it; and where birthing parents are adequately prepared and supported through it.

As it stands, birth trauma – which affects one in three mothers in Australia – can slip through gaps in pre- and post-natal education and support, with risk factors often overlooked and opportunities for early intervention missed.

However, Lim said greater collaboration, awareness, and screening could help - particularly if GPs are more frequently included in the conversation.

“We are very focussed on strengthening GP-led pathways for maternity care,” Lim said, ahead of his presentation at the Obstetric Medico Legal Conference.

“GPs can play a vital role in preventing birth trauma and providing that early support and intervention.

They are well-placed to follow up with patients and continue to provide support women and their families long after they have been discharged from maternity services.

“In the same vein, many services around the country are developing Debriefing Services where women - and their birth partners - are given opportunities to talk about their birth experience.”

Birth trauma can have a delayed onset

At present, much of this care comes from midwives and obstetricians in the immediate aftermath of giving birth. However, not all forms of birth trauma are detectable in this early postnatal period.

Psychological injuries, such as post-traumatic stress disorder (PTSD) – which impact one in ten mothers who experience a traumatic birth - are delayed in 25% of cases.

There may also be confounding variables in a hospital setting, such as anaesthetic recovery and acute sleep deprivation, the side-effects of which could mimic traumatic stress.

“I think there's been a lot of focus on midwifery and obstetric care, but bringing GPs into the picture here is very important. They can provide care beyond six weeks into the postnatal period and continue that care for the rest of the woman's life and before her next pregnancy,” Lim said.

Lim highlights that in rural, regional and remote Australia, GPs already provide extensive obstetric care, many holding the title of GP Obstetrician. He believes the model works well but the dwindling national supply of these professionals is putting this model at risk.

“The numbers of GP Obstetricians are going down. So, I think it's important that we support GP training and encourage those who aren’t already doing dedicated obstetric care to participate in it more extensively,” he said.

Holistic care team

Despite the emphasis on GPs, Lim is clear that adequately managing birth trauma is a multidisciplinary effort and that contributions from physiotherapists and social workers are equally valued.

“Women who experience pelvic floor dysfunction, for example, depend on physiotherapist support and should be given equal focus in the discussion,” he said.

“Birth trauma is a multifaceted area and requires a multidisciplinary approach.”

Informed consent

RANZCOG is also focussed on improving informed consent during the birthing process – an issue that has become prominent in conversations around birth trauma.

A survey by the Australasian Birth Trauma Association (ABTA) found that 36% of parents agreed to birth interventions without fully understanding the associated risks.

ABTA also recognises that this is a significant contributing factor in psychological trauma during childbirth.

Lim said informed consent is about having a two-way conversation with birthing parents.

“It's not just about providing information and signing the consent form. It’s about involving parents in the discussion and reaching a joint decision.

“Parents need to understand why a caesarean section or induction of labour has been recommended because, as you would imagine, parents sometimes feel they have been coerced into accepting an intervention like this, especially when an emergency procedure has to be performed.”

Lim said this education should begin early in the antenatal period. He claims existing antenatal education is too focussed on normal birth outcomes.

“We need more discussion around interventions like instrumental birth, caesarean section, induction of labour – there’s not a lot of time spent on this.

“It’s understandable to an extent because, I think, parents, when they set out in their pregnancy journey, would like everything to be as normal as possible and achieve the best outcome. But sometimes this isn’t possible and we need to take a different path to keep mother and baby safe.”

Join the conversation

Professor Boon Lim will continue this discussion at the upcoming Obstetric Medico-Legal Conference, where he will provide detailed updates on RANZCOG’s recent birth trauma roundtable.

Joining him on the stage are representatives from Royal Women's Hospital Melbourne, Australian Centre for Health Law Research and Victorian Bar.

This year’s event will be held 13-14 August 2026 at Melbourne on Collins.

Learn more and register your tickets here.